FACT SHEET FOR PATIENTS AND FAMILIES

Elective : What to Expect

What is elective labor induction? Labor induction means inducing (starting) labor, rather than waiting for labor to begin on its own. When The day you give labor is induced for a nonmedical reason — such as is always exciting. The for personal choice or convenience — it’s called an information in this elective labor induction. handout can help you face this important day When labor is induced, a healthcare team will actively with extra knowledge work to start, monitor, and support your labor. This is and confidence. called active management. BEFORE YOU ARRIVE AT THE HOSPITAL Making sure you’re a good candidate for elective induction Active management starts before you arrive at the hospital. Your healthcare provider will determine if elective induction is right for you and your baby. Intermountain follows national guidelines that Research and experience show that following these limit elective inductions to women meeting certain standards help to make labor safer, easier, and usually standards. This means that before planning to induce shorter. They also help to make a — your labor, your doctor or midwife must: rather than a C-section delivery — more likely. •• Confirm that there’s nothing in your medical or Starting hospital preparations history that would make an induction If you meet the guidelines for elective induction, your dangerous for you or your baby. This includes provider will contact the hospital labor and delivery certain previous uterine surgeries, and certain unit. There, the healthcare team will review your positions of the baby or the placenta in the uterus. medical history and look at their schedule. They will •• Be certain of your due date and know that you call and tell you when to come to the hospital for are at least 39 weeks along in your pregnancy. your induction. This helps make sure that labor isn’t started too Note that sometimes a scheduled elective induction early or before your baby is fully developed. may be delayed. This is because the labor and delivery •• Determine that your is soft and ready department must give priority to women with more to dilate (open). Your provider can check your urgent medical needs. Your healthcare team will cervix to determine a . This score is the do their best to let you know if your time needs to standard way to see if the cervix is ready for labor. change. Still, prepare to be flexible.

1 AT THE HOSPITAL Managing labor pain Reviewing your history Generally speaking, choices for managing pain are When you arrive at the hospital, your healthcare the same whether your labor is induced or begins on team will review your medical and pregnancy history its own. Discuss options with your provider. You may with you. Try to be patient if they ask you a question decide to take pain medicine or not. The nurses will you’ve already answered. Double-checking is part of support your decision and do what they can to help the process to keep you and your baby safe. you have the birth experience you want. Keep in mind that with an induced labor, Checking your baby your contractions might be stronger and more Before beginning the induction, your healthcare team painful — especially early on — compared to natural will to check to confirm that: labor. If you decide to have pain medicine through an •• Your baby is in a good position in your uterus. epidural, talk to your provider about the timing of its A head-down position is best for a vaginal birth. placement and what you can expect.

To check your baby’s position, a member of your Intermountain’s fact sheet, FACT SHEET FOR PATIENTS AND FAMILIES Anesthesia for Labor and Delivery

Do I need pain medication? What are my choices? healthcare team will do a vaginal exam and will also Every woman experiences the pain of labor and The two main types of pain medications used in labor and Anesthesia for Labor and delivery differently. Many factors affect the pain you delivery are and anesthetics. may feel. These factors include the size and position of the • Analgesics, such as opioids (for example, fentanyl or baby, the strength of the contractions, and your own pain morphine), are medications that help relieve pain. They tolerance. The first step in managing your pain is to learn can lessen pain during labor, but do not completely get about your options and make a tentative plan. But stay rid of it. They can also reduce anxiety and help you flexible. The course of a baby’s birth can be unpredictable. relax. Analgesics cannot be given at the time of delivery. You may not need or even want pain medication. • Anesthetics are medications that can block most feel around the outside of your belly. An ultrasound feeling, including pain. Depending on how and where Some women have babies without pain medication. Delivery, explains options for They manage the intense feelings of in other they’re given, they can act on a specific area or region of your body, or on your whole body. ways, including relaxation and breathing exercises, hypnosis, and massage. These methods are often called – Local anesthetics, such as lidocaine, act only on a “natural” childbirth. If you want to give birth without specific area of your body. pain medication, it’s important to learn and practice the – Regional anesthetics, such as epidural and techniques of natural childbirth beforehand. spinal blocks, act on a specific region of the body. These options can be used for both vaginal and may also be done. You may change your mind as labor progresses. cesarean deliveries (c-sections). Epidural is the most Labor often hurts more than you anticipate. Changing common choice because it has the least sedative effect pain management, including your mind about pain relief is not a sign of weakness. and can be used throughout labor and delivery. Some women find that pain-relieving medication helps – General anesthetics block most sensation, including them feel more in control and less tired during childbirth. pain, and cause you to lose consciousness completely. Doctors sometimes suggest pain medication to help labor Because they have greater risks than regional progress or if complications arise. anesthetics, they’re only used in emergencies. All types of pain medication may affect your labor — and your baby — though most of these effects are temporary. options for relaxation and Use the table below to learn more. Then, discuss the options •• Your baby’s heartbeat doesn’t suggest any with your healthcare providers. Actions and What it is How it’s given potential benefits Potential risks or side effects Analgesics • Usually given through an IV or as an • Can lessen pain, reduce For you: (general pain injection (shot) into a muscle. Can anxiety, and help you • Does not completely eliminate pain. relieving also be injected into the epidural relax during labor. • May cause drowsiness or trouble concentrating. medications, space or into the spinal fluid. (See • Does not block all • May decrease your memory of labor. including opioids “how it’s given” under epidural block sensation and feeling. • May cause nausea, vomiting, or itching. breathing techniques. and spinal block for more information such as fentanyl • Does not cause you to • May decrease blood pressure or slow your breathing. problems. on this method of delivery). May give you an unwell or unhappy feeling. or morphine) lose consciousness. • A heart rate monitor will be used to If given through an IV or injected into May cause an allergic reaction and difficultly breathing. • Does not slow down • a muscle, the medication is carried • labor or interfere For your baby (if given too close to birth): in your bloodstream — so your baby with contractions. • May cause sleepiness, which may make it harder to gets it, too. How it affects your baby breastfeed (“latch on”) immediately after birth. depends on how much and how • May slow breathing and reflexes, and make it hard for 1 check your baby’s heart before starting the induction. close to delivery the drug is given. your baby to stay warm. Monitoring Starting and progressing labor As long as you’re receiving IV medicine, your There are several ways to safely induce labor. healthcare team will monitor your contractions and Intermountain routinely uses these two methods: your baby’s heart rate and wellbeing. Note that the •• Amniotomy [am-nee-OT-uh-mee]. If your sac of care team can see the information from your monitors amniotic fluid — or “bag of water” that surrounds at other stations outside of the delivery room. the baby in the uterus — doesn’t break on its own, If you have any questions during your time in the your provider may suggest an amniotomy. This hospital — about any part of your care, or about what involves making a small opening in the amniotic you see or feel — please ask someone on your medical sac with a thin plastic hook. You might feel a warm team. They welcome your questions and want to help. gush of fluid when the sac opens, but no pain. An amniotomy will increase your labor contractions. It can also allow providers to check the amniotic fluid for meconium [mi-KOH-nee-uh m] (the baby’s first stool). •• Pitocin [pi-TOH-sin] by IV. You’ll be given a medicine called Pitocin through a small tube — called an intravenous line (IV) — inserted into one of your veins. Soon afterward, you’ll feel contractions begin. It will feel like squeezing or cramping at first.

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